• Home
  • About Us
    • Annual Business Report
    • Board Community
    • Board of Directors
    • Bylaws and Strategic Plan
    • Call for Board Nominations
    • Committees
  • Continuing Education
    • Calendar
    • Coding Roundtables
    • On Demand Education
    • Speakers Bureau
  • HIM Careers
    • AHIMA-Certified Health Information Professionals
    • Colleges
    • HI Career Map
    • Job Board
    • Post a Job
    • Registered Apprenticeship Program
  • Members
    • Awards
    • Scholarship
    • Volunteer
  • Resources
    • Advertising Opportunities
    • AHIMA Engage
    • AHIMA Foundation
    • Consumer Engagement
    • Join
    • News
    • Newsletters
  • Contact Us

CMS NEWS: CMS Finalizes Hospital Outpatient and Ambulatory Surgical Center Policy and Payment Changes, Including Changes to the Two-Midnight Rule and Quality Reporting for 2016

Fact Sheet

For Immediate Release

October 30, 2015    

Contact: CMS Media Relations
(202) 690-6145 | CMS Media Inquiries

CMS Finalizes Hospital Outpatient and Ambulatory Surgical Center Policy and Payment Changes, Including Changes to the Two-Midnight Rule and Quality Reporting for 2016

The Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2016 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System policy changes, quality provisions, and payment rates final rule with comment period (OPPS/ASC final rule) [CMS-1633-FC] on October 30, 2015.

The CY 2016 OPPS/ASC final rule updates Medicare payment policies and rates for hospital outpatient departments (HOPDs), ASCs, and partial hospitalization services provided by community mental health centers (CMHCs), and refinements to programs that encourage high-quality care in these outpatient settings.  Approximately 4,000 hospitals and 60 CMHCs are paid under the OPPS, while approximately 5,300 ASCs are paid under the ASC payment system.  The OPPS provides payment for most HOPD services, including partial hospitalization services furnished by HOPDs and CMHCs.  OPPS payment amounts vary according to the Ambulatory Payment Classification (APC) group to which a service or procedure is assigned.  The final rule also includes important changes to the Two Midnight Rule effective beginning in CY 2016.  See the related fact sheet for detailed information.
Click here to read more:   https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-10-30-3.html

Fact Sheet: Two-Midnight Rule

In addition, On October 30, 2015, CMS released updates to the Two-Midnight rule regarding when inpatient admissions are appropriate for payment under Medicare Part A.  These changes continue CMS’ long-standing emphasis on the importance of a physician’s medical judgment in meeting the needs of Medicare beneficiaries.  These updates were included in the calendar year (CY) 2016 Hospital Outpatient Prospective Payment System (OPPS) final rule.

Click here to read more Two-Midnight Rule fact sheet:
https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-10-30-4.html

November 2, 2015 Christy

Resources

  • Advertising Opportunities
  • AHIMA Advocacy
    • Take Action!
  • AHIMA Engage
  • AHIMA Foundation
  • Consumer Engagement
  • Join
  • News
  • Newsletters

In the News

  • Take the Next Step in Leadership – Apply for an Elected Volunteer Position with AHIMA December 21, 2020
  • Need CE Hours? Haugen Consulting Group Educational Webinars December 14, 2020
  • AzACDIS Lunch & Learn: OIG Malnutrition Audits – Time for CDI to Up Their Game November 20, 2020
  • Have You Taken AHIMA’s Naming Policy Pledge? November 11, 2020
  • AzHIMA Virtual Annual Meeting – Registration Now Open! October 20, 2020

Engage

BlueButton

Follow Us

Follow Us EmailFollow Us FacebookFollow Us InstagramFollow Us LinkedInFollow Us Twitter

Search

Copyright © 2021 AzHIMA. All Rights Reserved. Powered by KnowledgeConnex | Privacy Policy